WORCESTER — UMass Memorial Health Care will post a $57 million operating loss for the 2013 fiscal year, which hospital officials say will necessitate another round of layoffs, service reductions and cost cutting at the region's largest health care provider.

A UMass Memorial Medical Center memo sent to employees Tuesday reported that the nonprofit hospital system will record its first operating loss in eight years for the 12-month period that ended Sept. 30.

However, UMMHC will post an approximate $75 million surplus, when investment income and revenue from the sale of two units is accounted for, according to hospital spokesman Robert Brogna.

Dr. Eric Dickson, president and chief executive officer of UMass Memorial Health Care, first told the hospital group's 13,000 or so employees about the operating losses in an Oct. 18 posting on his blog, www.everydayinnovators.org. Dr. Dickson promises to continue talking with UMMHC's employees on his blog and via email about the coming changes.

UMass Memorial ended the 2012 fiscal year with a $53.4 million surplus, including an operating surplus of $5 million on total revenue of $2.29 billion. For fiscal 2012, it had $48.4 million in investment gains.

In fiscal 2013, the hospital group sold its clinical outreach labs to Quest Diagnostics Inc., and its home health and hospice program to the VNA Care Network and Hospice. UMMHC shed about 750 employees in those two transactions.

UMass Memorial president Patrick C. Muldoon wrote in his memo, "We've been talking about this for years — our leaders have been warning us about growing costs, falling patient volumes, the impact of health care reforms and our slow response to our changes. But the size of this loss and the speed at which it is affecting us is truly unmatched."

According to the memo, $34 million of the operating loss occurred at UMass Memorial Medical Center, which has three Worcester campuses: University, Memorial and Hahnemann.

Mr. Brogna said that what was driving the losses at UMMHC were increased costs; falling inpatient volumes at all of its hospitals; increasing observation cases at all of its hospitals; reduced reimburesment rates and other costs associated with health care reform.

Inpatient stays, which are more profitable, declined from 59,000 in fiscal year 2009 to approximately 53,200 across the UMass Memorial Health Care system, Mr. Brogna said.

But observation cases, in which patients are watched by doctors and hospitals in a hospital bed for some serious health issue but not admitted to the hospital, are on the rise — and hospitals are reimbursed at a far lower rate for observation cases.

Observation volumes at UMMHC rose from 9,500 in fiscal year 2009 to 15,791 in fiscal year 2013, he said.

UMass Memorial Health Care, in addition to its flagship Worcester campuses, also consists of Clinton Hospital, Marlboro Hospital, HealthAlliance Hospital in Leominster and Fitchburg, Wing Memorial Hospital in Palmer, and a doctors' group with more than 1,000 doctors. The hospital group employs approximately 13,000 people.

In the memo, Mr. Muldoon wrote that employees should expect some "tough decisions about programs and services we offer, which will have an impact on the size of our workforce."

He wrote that the hospital group is "committed to finding ways to reduce costs while preserving as many jobs as possible."

He said that the layoffs and service reductions must be implemented within the next year.

UMass Memorial laid off 140 employees in September 2012 and shed 750 employees when it sold its clinical outreach labs and home health and hospice business units.

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